14 BIRMINGHAM POST THURSDAY, JUNE 11, 2015

NEWS

Huge steps forward at a Bir-mingham hospital have led to much better survival

rates for soldiers who have suffered terrible injuries in Iraq and Af-ghanistan.

The study, which has just been published in the Journal of Trauma, highlighted work at the Royal Cen-tre for Defence Medicine, which is based at the Queen elizabeth Hos-pital. But the report warned it was important to take action to ensure the expertise and lessons learned was not lost now the two major con-flicts had ended.

In the decade to 2012 there were 2,792 uK Military casualties, sus-taining 14,252 separate injuries – of which 608 died.

Around 70 per cent of all injuries came from explosions – and the report found over the ten years there was a marked improvement in survival rates.

Improvements in care meant that, over the course of the decade, an estimated 265 casualties survived injuries that would have been judged likely to be fatal at the start of the conflicts.

It found that 572 casualties sur-vived despite injuries classed by the NHS as “life-threatening”, while 38 casual-ties survived with injures classed

as “unsurvivable”. Three-quarters of combat casualties were due to explosive weapons, which is con-sistent with most of the major wars of the last century.

The evolution of a complex response package, beginning on the battlefield, including emergency surgery in Camp Bastion, Afghani-stan, and finally in Birmingham, was attributed to improvements in survival rates.

The study by Navy surgeons and an academic at the university of Birmingham has been described as the fullest examination of battle-field casualties released by a Nato member after a war.

Primary author of the study, Sur-geon Lieutenant Commander Jowan Penn-Barwell RN said: “While both the uK military and our American colleagues always believed that survival rates had improved, this is the first time that it has been demonstrated scientifically.

“This study is the most detailed analysis of combat casualties ever released on either side of the Atlan-tic and is the first to definitively prove that the huge efforts to

advance and improve the care of our wounded have been

enormously effective.“It is important to rec-

ognise that this work describes the efforts of thousands of people, from the patrol medics out on the ground, to

the vast range of sur-geons, physicians, nurs-es, therapists and scien-tists in both the Defence

Medical Services and the NHS, and most impor-

tantly the sacrifice of the 2,792 casualties, including

the 608 who died in service during this decade.”

The report found that returning patients to a

single treatment facility was an important factor, with the expertise con-centrated in one area.

It said: “Manage-ment of trauma in deployed uK Military medical facilities is

both consultant led and consultant delivered. With the high tempo and unpredictability of military opera-tions during the last decade, con-sultants have gained experience across multiple previous deploy-ments.

“This knowledge is further con-solidated by the cyclical predeploy-ment training system through which clinicians returning from deployment instruct their col-leagues about to deploy via the bespoke Military Operational Sur-gical Training (MOST) course run with the assistance of the Royal College of Surgeons of england since 2007.

“This team-based training involves rehearsing damage-con-trol resuscitation and surgical techniques on cadaveric material and third-generation simulation mannequins with the complete team of surgeons, anaesthetists, emergency physicians, and theatre staff using current equipment and protocols.”

The report said it was vital to ensure, for the good of future sol-diers, that the expertise is kept.

It said: “It is possible that improvements in uK military trau-ma system performance achieved during the last ten years might be lost at the cessation of hostilities.

“The associated decreased expo-sure to severe combat trauma may result in a loss of some of the gains in survival demonstrated by this study in the initial phases of subse-quent conflicts.”

And Lt Com Penn-Barwell added: “While it is hard to pin-point individual treatments or techniques that have led to the improvements in survival rates, we have examined every facet of our practice and worked hard to refine and improve it.

“We have done this again and again. And we have worked hard with our NHS colleagues to dis-seminate these vital, life-saving les-sons. It is now of the utmost impor-tance that these advances are maintained in order to care for cas-ualties during any future conflict and to the continued benefit of civilian healthcare.”

Major gains in trauma care ‘must not be lost’

Ben HurstStaff Reporterben.hurst@trinitymirror.com

A military amputee in the trauma ward at the Queen Elizabeth Hospital, right, during the recent Afghan conflict. Below, Lt Com Jowan Penn-Barwell >

MP in bid to close fancy dress loopholeA CITy MP is demanding a change in official safety rules to protect children from fancy dress costumes which catch fire easily – after TV host Claudia Winkleman’s daughter suffered horrific burns.

The Strictly Come Dancing presenter has revealed that her eight-year-old Matilda suf-fered severe injuries when her witch outfit caught alight last Hal-loween.

Now, high-profile Mid-land MP Tom Watson has joined calls to ensure that tough legal safety standards apply to fancy dress costumes.

Mr Watson, MP for West Bromwich east and one of the candidates standing for the deputy leadership of the Labour Party, is one of a number of MPs who have signed an official Commons motion demanding the government ends a loophole which means fancy dress costumes are classed as toys rather than clothing.

It means they are not subject to laws which state clothing must be flame-resistant before it can go on sale.

Claudia Winkleman >

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